Frequently asked questions

The anesthesia team manages pain before, during and after surgery.

Anesthesia consultation: A pre-operative anesthesia consultation is required. At the time of the consultation, an anesthetist will inform you of the anesthesia used and a general check-up will be performed.

If necessary, a call will be made to your general practitioner to complete the necessary complementary examinations.
The aim of the consultation is to identify the risk factors of each patient and to limit possible complications. It is therefore a necessary step in the course of treatment.

A few tips before your stay at the clinic

• Be present at the preoperative anesthesia consultation about 10 days before the operation.
• Inform those around you about the operation, so that you can optimize assistance with daily activities (shopping, housework, etc.) and certain ergonomic aspects of life (position of heavy everyday objects, possible clutter in the home, etc.).
• Pack comfortable clothes.
• Organize your toiletries.
• Valuables should be avoided in hospital, as the hospital will not accept responsibility for any loss.
• If you have allergies, bring the card with the list of allergies to the anaesthetist’s consultation and to the hospital on the day of the operation.
• The medications you usually take should be discussed with the anesthetist during the consultation, and a list of these should be brought to the clinic on the day of admission.

It is not necessary to stop taking cardio aspirin. With regard to Plavix®, any modification of this treatment should be discussed with your general practitioner and adapted according to the type of surgery.
In the case of anticoagulant treatment (Sintrom®, Xarelto®, Eliquis®), a relay with another anticoagulant should be planned, in discussion with your general practitioner, a few days before surgery to reduce the risk of bleeding.
Each case is individual and should be discussed with the surgeon and the doctor who prescribed the medication.

Hair removal prior to surgery is not recommended. Any sores on the skin may compromise the sterility of the operation, and may mean that the date of surgery has to be postponed.

Contact your physiotherapist as soon as possible, even before the operation, so that sessions can be started as soon as you return home. In general, 2 sessions a week are recommended for the first 6 weeks after surgery.

You must fast from midnight the day before your operation (unless otherwise instructed by the anesthesia team), which means “no eating, drinking or smoking”.

On arrival, you will be greeted by the nursing staff, who will settle you into your room. They will also explain how your stay will unfold and carry out pre-operative preparation, including “marking the side to be operated on”.

On the day of the operation, you will be transferred to the operating room and taken care of by the team responsible for your operation in the OR.
The operation generally lasts between 1 hour and 3 hours, depending on the type of surgery. After the operation and when you wake up, you will be taken to the “recovery room” or monitored for a few hours before returning to your room.

The surgeon makes his first visit at the end of the day, on the day of the operation.

Hospitalization generally lasts 2 to 3 nights. The duration will be discussed with the surgeon at the time of informed consent, but may change depending on events occurring during or after the operation. Ultimately, it is the care team that will decide on the ideal time for the patient to be discharged.

You will benefit from physiotherapy during your hospital stay, so that you can start your rehabilitation early. It is important to carefully respect the postoperative limitations indicated by the surgeon, which may vary according to the operation and intraoperative aspects. If you are unsure, don’t hesitate to ask your physiotherapist and surgeon.
The physiotherapist also plays an important role in the ergonomic aspects of daily activities, offering techniques and advice on how to perform movements such as dressing, bathing, getting in and out of bed, and moving around in familiar environments such as the kitchen. He or she will also teach you self-mobilization exercises for the operated limb, to be performed on a daily basis.

DAILY EXERCISES FROM THE FIRST DAY AFTER OPERATION:
Elbow: bend and extend the forearm while helping with the other hand.
Wrists: make small circles clockwise and anticlockwise.
Fingers: gently squeeze a ball, open and close the hand, spread the fingers.
Neck: tilt your head to the right and left.

In general, hospitalization lasts 2 or 3 days, but certain conditions must be met: optimal pain management; good scar progression; understanding of the rules of mobilization and splint manipulation. The physiotherapist and physician confirm these points before discharge.

These documents will be given to you when you leave the clinic (adapted according to the type of surgery):

• The date of your next visit to your surgeon.
• A prescription for painkillers
• A prescription for outpatient physiotherapy
• Medical certificate of incapacity for work (if indicated)

The type of immobilization (orthosis, also called splint) varies according to the type of surgery. The brace is applied in the operating room, and is usually worn for 6 weeks. Depending on the type of surgery, the brace may need to be worn 24 hours a day (except during physiotherapy sessions, home exercises and bathing) or for comfort purposes (i.e. when moving around outdoors, in high-risk environments (with lots of people or children around) and at night).
Even in the early post-operative phases, the elbow and hand can perform active movements without load.

If the brace is not properly positioned or causes pressure points on the skin, you should visit your physiotherapist or doctor to optimize ergonomics.

After shoulder or elbow surgery, some pain is normal. Hematoma and swelling can also occur postoperatively.
To reduce these effects:

• Medication will be prescribed. It is important to follow the prescription for the first few days of surgery, and then adapt the amount of medication to the intensity of the pain.
• Ice can be applied. To optimize the effect, apply ice every two hours for 15-20 minutes. It’s important not to put the ice in direct contact with your skin: put the ice in a plastic bag and wrap it in a cloth.

Particularly during the first 2-3 weeks, analgesic medication is important to make the pain bearable for daily activities, and to enable rapid mobilization of the operated limb.

Here are the signs to look out for after surgery

• fever over 38.5 °C .
• pain worsens despite taking the prescribed medication (according to the maximum authorized dose)
• discharge of pus from the scar
• Persistent numbness and/or loss of sensation in the arm or fingers that does not improve with a change of position.

If you notice any of these signs, contact your surgeon or GP, or go to the emergency room immediately.

The length of time the dressing will remain in place will be specified when you leave hospital. Scars are generally protected for the first 2 weeks after surgery.

To reduce the risk of infection, the scar(s) should not be exposed to water. Bathing is not permitted until the scar is completely closed. It is also important not to apply cream to the scar for the first 2 weeks.

If the dressing accidentally gets wet, it must be changed quickly to reduce the risk of infection.
To clean the armpit on the surgical side, gently bend forward so that gravity pulls the elbow away from the rest of the body. Dry thoroughly to avoid skin irritation.

Always put on the sleeve on the operated side first. Lean forward or towards the operated side to move your elbow slightly away from your body. Unloaded elbow and hand movements are generally permitted from the first few days.

Undress: Remove the sleeve on the NON-operated side first, then the sleeve on the operated side last.

To sleep: on your non-operated side, or on your back with a pillow under your operated arm for greater comfort. In the case of shoulder surgery, a semi-seated position may be the most comfortable. Do not sleep on the operated side.

No driving, carrying a load, pushing/pulling with the arm, putting the hand behind the back, leaning on the arm for at least 6 weeks (these instructions are adapted according to the type of surgery).

The answer depends on the type of operation and whether it involves the shoulder or the elbow. In general, most surgical procedures involve an inability to drive for around six weeks. In all cases, it is forbidden to drive a car while wearing a splint.

If the patient is unable to return home after the operation for reasons related to the inability to meet daily needs, or if intensive rehabilitation is required, several solutions are possible. These will be discussed with the patient’s office, which is responsible for organizing rehabilitation, care or temporary periods in a home for the elderly, as required. Home help from a socio-medical center for various activities can often be a good solution, which can be tailored to each individual patient.